Local reporters, editors, data crunchers win health journalism awards

A lot of the heath care journalism awards out there are kind of soft — they come from trade or industry groups. They have their own place on our walls, and, in some cases, we appreciate them. (In other cases, an award may represent a conflict of interest.  An award from an institutions you cover? Just say no. )

But the Association of Healthcare Journalists awards come with a lot of cred. And the  New England awards are well deserved. Congratulations colleagues. We get a chance to thank you in person when the AHCJ holds its annual meeting in Boston in two weeks.

Public Health (Large)

First: Coverage of Fungal Meningitis Outbreak Tied to Contaminated Drugs; Staff, The Boston Globe

Honorable mention: Cancer’s New Battleground: The Developing World; Joanne Silberner, David Baron, PRI’s The World

Consumer/Feature (Large)

Third: A Rampant Prescription, a Hidden Peril; Kay Lazar, Matt Carroll, The Boston Globe

Consumer/Feature (Small)

Second: Gift from Grief; Michael Morton, MetroWest Daily News (Framingham, Mass.)

Third: Demand for Home Care Workers Soaring, But Will There Be Enough Takers?; Arielle Levin Becker, The Connecticut Mirror

 Special citation: 40% of High-Prescribing Docs Get Pharma Perks; Lisa Chedekel, The Connecticut Health Investigative Team

Two April events: #Crowd-sourced #health care, #science and the lay #press

Your scribe here, Tinker Ready, appears at the second event on science and the media.

Deleterious Me: Whole Genome Sequencing, 23andMe, and the Crowd-Sourced Health Care Revolution

Anne Wojcicki

With panel discussion by Archon Fung, Jeremy Greene, Sanford Kwinter, and Jonathan Zittrain. Moderated by Sheila Jasanoff.

April 17, 2012, 5:00pm–7:00pm

Emerson Hall, Room 105

Co-sponsored by the Harvard University Center for the Environment, the Harvard School of Engineering and Applied Sciences, and the Harvard University Graduate School of Design.

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Standing Up for Science Media Workshop

Part of the Cambridge Science Festival

Broad Institute | 7 Cambridge Center

Cambridge, MA 02142, United States

Tuesday April 24, 2012

10.00 am Registration

Map of the location: http://g.co/maps/fn2uh

10.30 – 12.00 pm Science and the media

What happens when research announcements go wrong, statistics are

manipulated, risk factors are distorted, or the discussions become polarised?

Panellists: Dr Shawn Douglas, Fellow at the Wyss Institute for Biologically

Inspired Engineering; Professor Lorna Gibson, Professor of Materials Science

and Engineering, MIT; Dr Willy Lensch, Principal Faculty and Faculty Director of

Education, Harvard Stem Cell Institute.

12.00 – 1.10 pm Group work and lunch. Lunch will be provided.

1.10 – 2.30 pm What are journalists looking for?

How do journalists approach stories, balance the need for news and

entertainment with reporting science, and deal with accusations of polarising

debates and misrepresenting facts?

Panellists: Gino del Guercio, documentary filmmaker, Adjunct Professor, Boston

University’s College of Communication; Tinker Ready, freelance health and

science writer, Boston Health News & Nature Boston; Stephen Smith, City

Editor, Boston Globe.

2.30 – 3.10 pm Group work

3.10 – 4.15 pm Standing up for science – the nuts and bolts

Practical guidance for early career researchers to get their voices heard in

debates about science, how to respond to bad science when you see it, and top

tips for if you come face-to-face with a journalist.

Panellists: B. D. Colen, Sr. Communications Officer for University Science,

Harvard University; Leonor Sierra, Science and Policy Manager, Sense About

Science; Luke Stoeckel, Director of Clinical Neuroscience and Staff Training,

MGH-Harvard Center for Addiction Medicine, & VoYS US Representative.

4.15pm Close and informal feedback

End of Day Please join us for a drink

Lack of autopsies = missed medical errors: a Pro Publica investigation

This story notes that “when patients were autopsied, major errors related to the principle diagnosis or underlying cause of death were found in one of four cases. In one of 10 cases, the error appeared severe enough to have led to the patient’s death.”

So, it is bad news that all of the New England states report low autopsy rates in cases of unexpected deaths. Personally, it’s sad that NC also reports a low rate.  The Raleigh News & Observer  did a similar same story in 1995.

Without Autopsies, Hospitals Bury Their Mistakes

by Marshall Allen ProPublica, Dec. 15, 2011, 12:36 p.m.by Marshall Allen, ProPublica, Dec. 15

When Renee Royak-Schaler unexpectedly collapsed and died on May 22, no one ordered anautopsy.

Not the doctors at Howard County General Hospital in Columbia, Md., where the 64-year-old professor and cancer researcher was pronounced dead.

Not the Maryland Office of the Chief Medical Examiner, which passed on the case because no foul play was involved.

And not Royak-Schaler’s physicians at Johns Hopkins University School of Medicine who had diagnosed cancer in her hip two days beforehand but acknowledged they didn’t know what had caused her unforeseen death.

A half-century ago, an autopsy would have been routine. Autopsies, sometimes called the ultimate medical audit, were an integral part of American health care, performed on roughly half of all patients who died in hospitals. Today, data from the Centers for Disease Control and Prevention show, they are conducted on about 5 percent of such patients.

As Royak-Schaler’s husband, Jeffrey Schaler, discovered, even sudden unexpected deaths do not trigger postmortem reviews. Hospitals are not required to offer or perform autopsies. Insurers don’t pay for them. Some facilities and doctors shy away from them, fearing they may reveal malpractice. The downward trend is well-known — it’s been studied for years.

What has not been appreciated, pathologists and public health officials say, are the far-reaching consequences for U.S. health care of minuscule autopsy rates.

Diagnostic errors,which studies show are common, go undiscovered, allowing physicians to practice on other patients with a false sense of security. Opportunities are lost tolearn about the effectiveness of medical treatments and the progression ofdiseases. Inaccurate information winds up on death certificates, undermining thereliability of crucial health statistics.

It was only because of Royak-Schaler’s connections that her case ended differently. Her colleagues at the University of Maryland School of Medicine urged her husband to authorize an autopsy and volunteered to conduct it for free.

In her case, as in so many, the autopsy revealed a surprise: Royak-Schaler, the renowned cancer researcher, had cancer ravaging her body — in her lungs, kidneys ,abdomen and the marrow of her bones. A blood clot, likely related to thetumors, caused her sudden death.

Jeffrey Schaler has wrestled with anger that his wife wasn’t diagnosed sooner but said knowing how she died was better than not.

“There’s a sense of peace that accompanies that knowledge,” he said.

For the last year, ProPublica, PBS “Frontline” and NPR have probed America’s deeply flawed system of death investigation [1], focusing primarily on forensic autopsies, which are conducted by coroners’ offices and medical examiners when there is suspicion of an unnatural death. State laws vary, but the preponderance of deaths that occur in hospitals are considered natural. Whendeaths are unexplained, unobserved or within 24 hours of admission, hospitalsmay be required to report them to local coroners or medical examiners, but such  agencies rarely take hospital cases.

The NYTimes and the Dartmouth Atlas

The Science Journalism Tracker, from the Knight science writing program at MIT, offers helpful analysis. Yesterday, it took on a New York Times story on the Dartmouth Atlas. The Times report cited take-downs of the program’s mapping of health care costs and practice pattern variations.  

 The maps “appeared to show where the waste in the system could be found. Beige meant hospitals and regions that offered good, efficient care; chocolate meant bad and inefficient.  

The maps made reform seem relatively easy to many in Congress, some of whom demanded the administration simply trim the money Medicare pays to hospitals and doctors in the brown zones. The administration promised to seriously consider doing just that.

But while the research compiled in the Dartmouth Atlas of Health Care has been widely interpreted as showing the country’s best and worst care, the Dartmouth researchers themselves acknowledged in interviews that in fact it mainly shows the varying costs of care in the government’s Medicare program. Measures of the quality of care are not part of the formula.

For all anyone knows, patients could be dying in far greater numbers in hospitals in the beige regions than hospitals in the brown ones, and Dartmouth’s maps would not pick up that difference. As any shopper knows, cheaper does not always mean better.

Here’s what the science trackers had to say:

Their bias is evident from the start. They describe the study in the lede as coming from “a once obscure research group” at Dartmouth. You see how clever that is? Without actually pointing to any problems with the study, they suggest that there’s something fishy about it. How important could this study be if it comes from an obscure research group?

 Actually, Elliott Fisher, one of the authors of the Dartmouth atlas who is quoted lower in the story, is one of the nation’s leading health-care economists. I’m sure he was obscure once (wasn’t everybody?), but he’s not anymore, and he hasn’t been for a long time.

 

The once obscure Abelson and Harris then note that the study has been “widely interpreted” as showing the country’s best and worst care, but that all it does is show the variations in cost. Here’s the problem with that observation: Showing the difference in costs is precisely what the study’s authors say it does. Fisher says so in the story!

Fisher does, however, admit that both he and others have miscast the findings at times.

No doubt in the truth that cheaper is not always better, as the Times story says.  But it is also true that  more-is-better has been the mantra of both patients and provider for years. The result: massive waste and poor care. While cost may be a crude measure, it is an important red flag.  Studies like these need to control for as much as possible and recognize the limits of the findings.

Gooz News call is an “important debate.”

 No letters up on the Time yet but find some reaction on the Dartmouth site.  More from the blogs here.

Is Fox-Boston passing off Beth Israel PR as news?

This from the Association of Health Care Journalists.

Hospital says it gives content to short-staffed media

Nov. 12th, 2009 by Pia Christensen

Lindsey Miller of Ragan Communications Inc., a publisher of corporate communications, writes that Boston’s Beth Israel Deaconess Medical Center has found a way to “spread its message“ – by providing content to the area’s short-staffed television stations.

The (BIDMC) hospital’s director of marketing communications says she has flipped the problem of reduced local medical reporting due to layoffs to her advantage by providing features and experts to help fill the gap, particularly at TV stations such as Boston’s Fox affiliate.

NPR’s Rovner on health reform in DC, plus Senate testimony

Julie Rover covers health policy for NPR. She was doing it when I was in DC  in the early 1990s. She speaks wisely and cuts through the hype. Listen to her comments on the cost cutting meeting here.

Here’s the intro: A key Senate committee will examine options to pay for an overhaul of the health care system. On Monday, the president met with leaders of the health care industry who pledged to reduce costs. Health care experts are trying to decide whether that deal represents an actual breakthrough — or a publicity stunt.

Also, C-Span broadcast the latest Senate Finance meeting on the reform bill.

Locals scheduled to appear and their written statements:

• Stuart H. Altman, Professor of National Health Policy, HellerSchool for Social Policy and Management, Brandeis Universit.y
• Katherine Baicker, Ph.D., Professor of Health Economics, Harvard School of Public Health.
•  Jonathan Gruber, Ph.D., Professor of Economics, Massachusetts Institute of Technology.

Hospital chief calls for “blog rally” to save The Boston Globe

      I’ve written a lot of stories that exposed some unpleasant things about very good hospitals. And I’ll write some more, I imagine.

            In journalism, you are always in danger of alienating thin-skinned sources. So, it was interesting to see a BI chief Paul Levy lead the blog charge to save The Boston Globe.

            A quick review of the Globe archives finds that Levy, personally, has good reason to support the paper. A recent column praising his handling of potential layoffs drew a strong response. And, a Globe investigation in December reported that BI rival, Partners Healthcare, had been gaming the system in a way that raised the cost of health insurance  in the state.    

            I think the Globe does a great job covering hospitals with the staff they have left. And I don’t think they favor Levy. But he does get a lot of good press, despite a campaign by the healthcare workers union, 1199 SEIU, that charges the hospital with everything from union busting to poor patient care.

            Still, give Levy credit for recognizing that health care will suffer with the demise of reporting — which is really what we are losing with newspapers. It is in the public’s interest to have professional reporters - not just bloggers – covering cities like Boston. Remember, the Herald has been teetering for years.

             We health reporters translate medical findings, cover providers and try to explain reform. Sometimes we actually produce something literary. And, like the reporters who cover government, we’re watchdogs. It’s not so-called “gotcha” journalism. We look at how things are supposed to work – like the FDA, Walter Reed Medical Center and Partners. If they’re not working that way, we look closer.

            Reporting is hard – I have to teach teenagers how to do it. And as imperfect as you think we are, you’ll miss us when we’re all gone. I often find the the NYTimes link to AP health and science news empty these days.

        I’m not saying we have to stick with the old, paper business model. But, we do need to find someway to preserve and support high quality, independent reporting.

Disclosure: A close family member works at the Globe